Technical Abstract:
Sepsis in preterm human infants has been associated with total parenteral nutrition (TPN), and it has been suggested that sepsis may occur due to translocation of gut luminal bacteria. In this study, we compared the effects of TPN versus enteral (ENT) feeding on intestinal bacteria translocation. Newborn, colostrum-deprived pigs (<24 h old) were fitted with intravenous catheters and divided into two groups. One group (n = 13) received TPN through intravenous feeding and the second group (n =14) was orally fed a commercial pig milk-replacer (ENT); nutrient intake did not differ between groups. After 7 d of treatment, pigs were euthanized and jejunum (J), ileum (I), cecum (C), liver, spleen, mesenteric lymph node, and blood were evaluated using restrictive media and serial dilutions to determine the presence and concentrations of enteric bacteria. ENT pigs had increased bacterial concentration and diversity of intestinal tract enterics compared to TPN pigs. The majority of positive samples in the TPN group were cultured from the C, with infrequent isolation from the J or I. Bacterial genera commonly isolated from the gut included Enterococci, Pediococci, Enterobacter, Staphylococci, Klebsiella, Citrobacter, and Clostridia. The ENT group had 1/14 positive for Clostrium difficile toxin A compared to 5/13 for the TPN group. Translocation of bacteria from the intestinal tract to tissues or blood was similar (8/14 ENT, 6/13 TPN) between groups. ENT pigs had increased concentrations and diversity of intestinal bacteria compared to TPN pigs. TPN pigs may be at higher risk for C. difficile colonization.